그레이브스병에서 방사성 요오드 치료에 따른 갑상선 자극 호르몬 수용체 결합억제 면역글로불린(Thyrotropin Binding Inhibitory Immunoglobulin, TBII)의 변화

조영석,권기현,이준철,나소영,이효진,홍우정,이유선,김군순,송민호,김영건,노흥규 충남대학교 의학연구소 2003 충남의대잡지 Vol.30 No.2

Prediction of thrapeutic response to radioiodine in Graves' disease is poorly understood. Although thyrotropin binding inhibitor immunoglobulin(TBII) level is a strong index for relapse after antithyroid drug medication, conflicting results are reported regarding its prognostic significance in Graves' disease treated with RAI. This study is dengned to evaluate possible relationship between post-treatment hypothyroidism and TBII in Graves' disease treated with RAI. Fourty two patient with Graves' disease after radioiodine treatment were studied retrospectively. The subject were divided into hypothyroid group and euthyroid or hyperthyroid group. We evaluated the association of hypothyroidism and TBII with radioiodine treatment dose. The mean age of hypothyroid group was 48±11 years and euthyroid or hyperthyroid group was 47±12 years. There was no difference in two groups. And there was no significant difference in post- treatment TBII between two groups(49.9±28.5%, 29.9±14.3%, p-value >0.05). The treatment-dose had no influence on post-treatment thyroid state. Euthyroid or hyperthyroid group was done with 13.6±6.9mCi and hypothyroid group was 17.0±10.4mCi(p-value > 0.05). TBII had no prognostic significance on long-term hypothyrodism in Graves' disease treated with radioiodine. And, treatment-dose had no influence on post-treatment thyroid state.

폐경후 골다공증 환자에서 체질량지수에 따른 Alendronate의 효과

조영석,나소영,이효진,홍우정,김군순,김도희,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.2

배경 : 폐경후 골다공증은 심각한 문제로 대두되고 있다. 현재 Alendronate는 폐경후 골다공증의 치료제로서 널리 쓰이고 있다. 저자는 Alendronate의 골밀도에 효과를 알아보고 골다공증의 위험인자에 따른 Alendronate의 반응 정도를 평가하기 위하여 본 연구를 수행하였다. 방법 : Alendronate를 평균 12개월간 복용한 35명의 폐경후 골다공증환자에서 체질량지수와 폐경후 기간에 따른 치료효과를 조사하였다. 결과 : 전체 대상군에서 Alendronate 10㎎을 12개월간 투여한후 골밀도의 평균 변화율은 요추와 대퇴골 경부에서 각각 7.83±7.39%와 2.99±9.22%이었다. 과체중군에서 평균변화율은 요추와 대퇴골 경부에서 각각 7.15±4.5%와 3.05±2.86%였다. 양군간에 통계적 유의성이 있는 차이는 없었다. 폐경후 7년이 경과되지 않은 군에서의 평균변화율은 요추와 대퇴골 경부에서 각각 6.9±5.3%와 5.71±0.08%였다. 양군간에 통계적인 유의성이 있는 차이는 없었다. 결론 : 마른체형이 골다공증의 발병에는 영향이 있으나, Alendronate 치료효과의 차이는 없는 것을 확인할 수 있었다. 더불어 폐경이 있고 7년이 초과된 군과 년이 경과되지 않은 군에서의 Alendronate 치료효과의 차이는 없는 것을 확인할수 있었다. 이는 골흡수가 상당히 진행된 상태에서도 Alendronate가 치료효과를 가지고 있음을 반영한다고 할 수 있겠다. Postmenopausal osteoporosis is a serious health problem. The aminophosphonate Alendronate is widely used for treatment of postmenopausal osteoporosis. We studied the effect of l0㎎ of alendronate given daily for mean 12 months on bone mineral density in 35 women(mean age 61yrs. mean BMI 23.24㎏/m^(2)) with osteoporosis. An over weight group is defined such that BMI was above 23㎏/m^(2). All the women received 1500㎎ calcium carbonate daily. The bone mineral density of L-spine and femoral neck was measured by dual-energy X-ray absorptiometry. Alendronate increased BMD at mean 12 months at the L-spine (7.15±4.5%) and femoral neck(3.05±2.86%) in normal women. Alendronate increased bone mineral density at 12 months at the L-spine(6.00±5.3%) and femoral neck(4.17±4.87%) in overweight women. There was no difference between two groups. In the less than 7 years group of postmenopausal duration. alendronate increased bone mineral density at 12 months at the L-spine(6.9±4.9%) and femoral neck(3.18±7.1%). In the more than 7 years group of postmenopausal duration, alendronate increased hone mineral density at 1% months at the L-spine(6.5±5.3%) and femoral neck(5.71±0.08%). There was no difference between two groups. In postmenopausal women with osteoporosis, therapy with alendronate produced significant increases in BMD of the L-spine and femoral neck in both group. There was no difference between normal and over-weight groups. and between less than 7 years group and more than 7 years group of postmenopausal duration.

교액성 폐쇄공탈장 1예

조태웅,민영돈,김경종,정권율,강성인,류소연,임성철 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.1

Obturator hernia is a rare pelvic hernia, occuring most frequently in elderly, extra-thin or debilitated women. Because of the anatomic character of the obturator foramen and the nonspecific symptoms in the presence of the hernia, the risk of strangulation of the herniated bowel is high, which leads to high morbidity and mortality rate. The authors experienced an unusual case of left obturator hernia with strangulation of the small bowel in an 80-year old female. The hernia was diagnosed by abdomino-pelvic computed tomography (CT) scan. Through the lower midline transperitoneal approach, resecting the strangulated small bowel, the hernia sac was ligated and the obturator foramen was repaired using adjacent broad ligament. We report these findings with a brief review of the literature.

야생 버섯을 복용 후 발생한 재생불량성 빈혈 1예

조소영,곽명옥,김정아,나현희,황동희,이홍기 仁濟大學校 白病院 2010 仁濟醫學 Vol.31 No.-

Aplastic anemia is one of the hematologic disease which is characterized by cytopenia in peripheral blood, hypocelluarity in bone marrow and marrow failure. Most common cause of aplastic anemia is unknown. Acquired causes of it are viral infection, drugs, and chemical agents. The symptoms of aplastic anemia are fatigue, headache, dizziness, exertional dyspnea, and pallor, and they are due to abrupt decrease in hemoglobin level. The incidence of acquired aplastic anemia is higher in Eastern population than Western. In geeral, men and women are affected with equal frequency, but the age distribution is biphasic, with the major peak in the teens and tweenties and a second rise in the elderly. We report a case of a 28-year-old man who experience aplastic anemia after ingestion of Cordyceps with the review of literatures.

사골 국물이 백김치의 품질에 미치는 영향

박영희,박소희,이종호,조재선 한국조리과학회 2003 한국식품조리과학회지 Vol.19 No.2

This study was conducted to investigate the effect of beef bone extracts on the organoleptic quality and fermentation of Baeck Kimchi. For this study, the organoleptic characteristics of Baeck Kimchi, with addition beef bone extracts were tested, and the changes in the fermentation factors, such as pH, acidity, reducing sugar and total microbial count, were observed during fermentation at 10℃ and 20℃. Greater amounts of lipids and soluble nitrogen were extracted to increasing the boiling time for the preparation of the beef bone extracts. However, 1% of the mixed beef bone extracts, prepared by boiling for 5, 7 and 9 hours, was the most acceptable for the Baeck Kimchi fermentation, as assessed from the results of sensory consumer tests. The beef bone extracts enhanced the umami taste of the unfermented Baeck Kimchi. The carbonated taste, sourness and fresh flavor of the fermented Baeck Kimchi were also enhanced. The fermentation rate was increased by the addition of beef bone extracts to Baeck Kimchi.

한국에서 메스암페타민 남용 또는 의존 환자의 인격장애에 관한 연구

김소영,권성민,조성남,권도훈,강병조,김형태 대한생물치료정신의학회 2003 생물치료정신의학 Vol.9 No.2

연구 목적 : 메스암페타민 남용 또는 의존이 없는 군과 있는 군 사이의 인격장애의 유병율을 알아보고, 메스암페타민 남용 또는 의존군에서 동반 인격장애가 그들의 전반적 기능 및 일반적 특성에 어떠한 영향을 미치는지 알아보고자 하였다. 방 법 : 대상은 정상대조군에서 메스암페타민 남용 또는 의존이 없는 50명과 정신병원에 입원한 메스암페타민 남용 또는 의존환자 50명이었다. 메스암페타민 남용과 전반적 기능에 대한 평가는 DSM-Ⅳ에 의거하였고, 인격장애를 평가하기 위해 대상군 모두에서 PDQ-4+를 시행하였다. 결 과 : 정상대조군은 34%에서 적어도 1개 이상의 인격장애를 나타내었으며, 한 사람 당 평균 3.94개였다. 메스암페타민 남용 또는 의존군은 64%에서 적어도 1개 이상의 인격장애를 보였으며, 한 환자 당 평균 4.72개였다. 메스암페타민 남용 또는 의존군에서 동반 인격장애의 유무는 시작 연령, 사용 용량, 그리고 입원 또는 구치 횟수와는 관련성이 없는 것으로 나타났으나, 3개 이상의 동반 인격장애를 가질 경우, 그렇지 않은 군에 비해 전반적 기능이 떨어졌다. 결 론 : 본 연구 결과, 우리나라에서도 일반인에 비해 물질사용장애 환자에서 인격장애를 동반할 가능성이 높으며, 물질사용장애 환자 중에서도 인격장애를 동반한 군이 그렇지 않은 군에 비해 전반적으로 기능이 떨어진다는 결론이 가능하게 되었다. Objectives : The purpose of this study was to examine the prevalence of personality disorders between normal control group and hospitalized methamphetamine abuse or dependent patients and, among the latter, the influence of comorbid personality disorder on their global assesment function and general characteristics. Methods : Subjects were 50 non-methamphetamine abuse or dependent persons in the general population group and 50 methamphetamine abuse or dependent patients admitted to the psychiatric hospital. Methamphetamine abuse or dependence and the global assesment function were diagnosed according to DSM-Ⅳ, and the presence of personality disorder was assessed with the PDQ-4+. Results : In the normal control group, 34% of subjects had at least one personality disorder and the average number of personality disorder was 3.94 per person. In the methamphetamine abuse or dependent group, 64% of the patients had at least one personality disorder and the average number .of personality disorder was 4.72 per patient. The presence of comorbid personality disorder were not associated with onset age, use dosage and the number of admission or arrest among the methamphetamine abuse or dependent group. But, when methamphetamine abuse or dependent patients had more than three personality disorders, the global assessment function was impaired. Conclusion : In our study, substance use disorder patients had the higher possibility of comorbid personality disorder in Korea, and among substance use disorder patients, those with comorbid personality disorders were associated with the greater global impairment.

자발성 뇌지주막하출혈 환자에서 Cardiac Troponin Ⅰ를 이용한 심근손상의 발생율

김용권,류진호,소정일,문원식,전병조,허탁,민용일 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4

Background : More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patients with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). Methods : A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. Results : Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). Conclusion : The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.

HBx형질전환 생쥐에서 발생한 간세포암종에서 H-ras 및 c-myc의 발현에 관한 연구

문형배,소병준,김학철,윤기중,한원철,조향정,유대열,정영진 圓光大學校 醫科學硏究所 2002 圓光醫科學 Vol.17 No.2

<연구목적> HBx형질전환 생쥐에서 발생한 간세포암종의 발암과정에 종양유전자(H-rgs, c-myc)의 발현 정도를 조사하고자 하였다. <연구방법> 정상생쥐 12마리(4-18개월) 및 HBx 형질전환 생쥐 44마리(4-18개월)를 대상으로 포르말린에 고정하고 파라핀에 포매한 간 조직을 이용하여 면역조직화학적염색을 실시하였다. 실험군은 정상 부위, 이형성 부위 및 종양 부위로 구분하였으며, 종양 부위는 소결절성병변 부위와 간세 포암종 부위로 구분하였고, 이형성병변 부위는 이형성병변만 발견되는 부위, 소결절성병변과 동반된 이형성병변 부위 및 간세포암종과 동반된 이형성병변 부위로 구분하였다. <연구결과> H-rgs의 발현은 정상 간조직에 비하여 이형성병변 부위(P<0.05) 및 종양 부위(P<0.01)에서 증가하였으며, 소결절성병변 부위과 간세포암종 부위 사이에서는 간세포암종 부위에서 증가된 경향이었으나 통계학적으로 유의한 차이가 없었으며, 각 이형성병변 부위 사이에서도 유의한 차이는 없었다. c-myc의 발현은 정상 간조직 및 이형성병변 부위에 비해 종양 부위에서 증가하였으며(P<0.001), 소결절성병변 부위와 간세포암종 부위에서는 비슷하였고, 각 이형성병변부위 사이에서도 비슷하였다. <결론> HBx형질전환 생쥐에서 발생하는 간세포암종의 발생에 H-rgs는 이형성 변화를 일으키는 시기에 관여하며, c-myc은 이형성병변에서 암으로 이행하는 시기에 관여할 것으로 생각한다. Background: This experiment was designed for the expression of H-ras and c-myc in hepatocarcinogenesis of the HBx transgenic mice. Methods: Immunohistochemical stains in the paraffin embedded tissue of the liver were used for the detection of H-ras and c-myc in the 12 normal mice and 44 HBx transgenic mice of the 4-18 month old. Results: Expression of the H-ras was significantly increased in the dysplastic area (P<0.05) and tumor area (P<0.01) than in the normal liver. But there were no differences of H-ras expression between areas of microscopically identified hepatocellular carcinoma (MI-HCC) and grossly identified hepatocellular carcinoma (GI-HCC) and dysplastic areas among the only dysplastic areas, dysplastic areas with MI-HCC and GI-HCC. Expression of the c-myc was significantly increased in the tumor area (P<0.001) than in the normal liver and dysplastic area. But there were no differences of c-myc expression between areas of MI-HCC and GI-HCC, and dysplastic areas among only dysplastic areas, dysplastic areas with MI-HCC and GI-HCC. Conclusions: Our study suggests that H-ras is related to the dysplastic change and c-myc is related to the neoplastic change in the hepatocarcinogenesis of the HBx transgenic mice.

편도체 기저외측핵의 AP5 투여가 상승된 경악반응의 습득에 미치는 영향

서미숙,조소현,김기석,이만영 한국심리학회 한국심리학회지 생물 및 생리 Vol.5 No.1

본 연구는 고전적 공포조건화에 관여하는 장소로 알려진 편도체의 기저 외측핵에 장기상승작용(Long-Term Potentiation: LTP)의 생성을 차단하는 약물인 MNDA (N-methyl-D-aspartate)길항제 AP5를 미세주입함으로써 시각적 조건자극(CS)을 사용한 경우에, 상승된 경악 반응의 습득이 차단되는지를 보고자 하였다. 동물은 AP5-AP5, AP5-식염수, 식염수-AP5, 식염수-식염수 집단으로 나누어서 CS-US 배쌍직전에 AP5나 식염수를 주입한 후 훈련시켰다고 다시 검사직전에 AP5 혹은 식염수를 주입하였다. AP5-AP5집단과 AP5-식염수집단은 상승된 경악반응을 보이지 않았고, 식염수-AP5, 식염수-식염수 집단은 상승된 경악반응을 보였다. CS-US배쌍 직전에 주입한 AP5는 상승된 경악반응을 차단하였고, 검사직전에 주입한 AP5는 상승된 경악반응을 차단하지 않은 결과는 AP5가 습득을 차단했으되 그 표현에는 영향을 미치지 않았다고 해석된다. 그리고 AP5-AP5, AP5-식염수 집단이 상승률에서 유의미한 차이를 보이지 않았으므로, 상승된 경악반응의 차단이 상태의존적 인출 실패에 기인한 것이 아니고, AP5 자체의 약효때문임을 알 수 있다. It has been known that the amygadala is the neural substrate for conditioned fear as well as unconditioned fear. Among the substructures of amygdala, the basolateral nucleus where CS and US inputs converge and LTP occurs, contains high densities of NMDA receptors and so seems to have a critical role in synaptiplasticity. NMDA antagonist, AP5 prevent induction of Long-term potentiation, but not expression of LTP. LTP is an activity dependent enhancement of synaptic efficacy and is regarded the psysiological mechanisms that might underlie learning and memory. So this experiment was done to investigate what effect AP5 injection to the basolateral amygdala on the acquisition and expression of the fear conditioning, using the fear potentiated Startle paradigm. Animals were allocated to AP5-AP5, AP5-saline, saline-AP5, saline-saline groups. AP5 or saline was injected just before conditioning and testing. The re sult is that AP5-AP5, AP5-saline group didn't show the potentiated startle, comparative to the saline-AP5, saline-saline group, and AP5-AP5 group is not significantly different from AP5-saline. So we conclude that AP5 blocked the acquisition but not expression of conditio-ned fear-potentiated startle and convince that the blocking is not due to state-dependent retrieval failure.

양성 갑상선 결절에서의 무수 알코올 치료 효과

김도희,나소영,이효진,홍우정,김군순,조영석,구본정,송민호,김영건,노흥규 충남대학교 의과대학 의학연구소 2002 충남의대잡지 Vol.29 No.1

목적 : 양성 갑상선 결절 환자에서의 PEI의 치료효과 및 부작용을 알아보고자 하였다. 방법 : 양성 갑상선 결절 환자 88명을 대상으로 초음파 소견에 따라 낭종성 결절, 복합성 결절, 고형성 결절 등 세 그룹으로 분류후 전체 및 각각에 대한 PEI의 치료효과 및 부작용을 조사하였다. 결과 : 양성 갑상선 결절 환자 88명을 PEI로 치료후 결절의 크기가 50%이상 감소한 경우는 전체 환자중 77.2%이었고 각 결절별로 살펴보면 고형성 결절에서 52.6%, 복합성 결절에서 72.4%, 낭종성 결절은 92.5%이었다. 부작용은 동통, 결절내 출혈, 감염, 결절의 누출등이 있었으나 대부분 무증상이었다. 결론 : PEI는 양성 갑상선 결절 환자증 적응증을 잘 살펴 고려해 볼 수 있는 치료법이라 생각되며 특히 낭종성 결절 환자에서 주사기에 의한 흡인후에 재발한 경우 일차적인 치료로 PEI를 고려해 볼 수 있겠다. Ultrasonography(US)-guided percutaneous ethanol injection (PEI) has been performed for the treatment of autonomous functioning thyroid nodules, thyroid cysts, & cold thyroid nodules. The author studied the efficacy of PEI in the treatment of benign cold thyroid nodules both solid and cystic (complex & pure). Eighty-eight euthyroid outpatients (age:44.2±13.9years, 75 women and 13 men) with benign cold thyroid nodules or simple thyroid cysts (69 with a single nodule and 19 with a prominent nodule within multinodular goiter) were includied in this study. After PEI, each subtype of thyroid nodules was divided into three groups in according to volume reduction complete response (90% or more of volume reduction), partial response (50% or more of reducton but below 90%), and failure (below 50% or increase in size) group. Overall response rates of PEI for benign thyroid nodules were complete 45(51.1%), partial 23(26.1%), failure 20(22.7%). In 20 cold solid nodules, complete response was observed in 6(30.0%), partial response in 5(25.0%), and failure in 9(45.0%). In 28 complex cysts, complete response was observed in 8(28.6%), partial response in 12 (42.9%), and failure in 8(28.6%). In 40 pure cysts, complete response was observed in 31(77.5%), partial response in 6 (15.0%), and failure in 3 (7.5%). Side effects comprised pain 8 (9.2%), intranodular bleeding 13 (14.6%), extracapsular leakage 1(1.1%), infection 1 (1.1%), increased size l(1.1%), and none 64(72.7%). PEI may prove a safe & effective tool for the therapy of cold thyroid nodules in selected cases and may be the treatment of choice of recurrent thyroid cysts. However, further investigation involving a larger number of patients and a longer follow-up is needed.